Individual
ANTAWANNA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
601 WILMINGTON ST, BEAUFORT, SC 29902-4956
(843) 525-7615
Mailing address
728 17TH ST, PORT ROYAL, SC 29935-2017
(843) 812-3672
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
218038
SC
Other
Enumeration date
08/19/2014
Last updated
08/19/2014
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